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Thread: Will pd change on an adult?

  1. #1
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    Will pd change on an adult?

    I had a patient who got progressive lenses from our place since 2009, the PD was 62, today he came in and got a pair of eyeglasses, he is a elder around age 75, I guess? The PD I got was around 65. Is it possible for the pd change? One of his eye is nearsighted, the other one is far sighted.

    By the way, he has few pairs of eyeglasses, most of them are from our place, so I think keep PD 62 is better since he is gonna switch glasses. The lasted eyeglass he got was from last year. It was 62 Pd on file.

    Thanks��

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    Cataract surgery? Do they have a history of amblyopia? If you were measuring with a corneal reflex pupilometer and they have had an IOL implant there will be a reflection off the implanted lens that is different than a healthy cornea would provide. Does he have an old orbital socket injury that is "settling" in his old age?

    If he is having some kind of shift from his muscles weakening and is amblyopic, change only a little bit at a time. Less is more, but in that case the change is warranted.

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    Thank you. I asked patient's daughter, she said he didn't do the surgery, so I was surprised.
    He had a history of amblyopia.

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    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by Xiatian123 View Post
    I had a patient who got progressive lenses from our place since 2009, the PD was 62, today he came in and got a pair of eyeglasses, he is a elder around age 75, I guess? The PD I got was around 65. Is it possible for the pd change? One of his eye is nearsighted, the other one is far sighted.

    By the way, he has few pairs of eyeglasses, most of them are from our place, so I think keep PD 62 is better since he is gonna switch glasses. The lasted eyeglass he got was from last year. It was 62 Pd on file.

    Thanks🙏
    Quote Originally Posted by Xiatian123 View Post
    Thank you. I asked patient's daughter, she said he didn't do the surgery, so I was surprised.
    He had a history of amblyopia.
    The current study also demonstrated that IPD increased by 4.19 mm in males and 3.11 mm in females from the young adults (20–30 years) to older adults (51–70 years), and then a decrease (2.6 and 0.19 mm for males and females, respectively) occurred between 70 and 89 years of age. This result can be explained by orbital involutional changes and the increased laxity of soft tissues in the elderly subjects.

    https://www.dovepress.com/evaluation...t-article-OPTH

    I've occasionally seen increases in the distance IPDs with my older clients of about 1mm to 2mm O.U., generally from middle age through their senior years, along with changes in the vertical position of the eyes.

    Always measure the IPD for new Rx lens(es), especially if the frame has changed, and expect to see more height disparities. Measure with the fellow eye occluded if the amblyopic eye turns.

    Best regards,

    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    An expert is a man who has made all the mistakes which can be made, in a narrow field. -Niels Bohr

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    Master OptiBoarder OptiBoard Silver Supporter
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    That is really interesting Robert, thank you for that article.

  6. #6
    Ghost in the OptiMachine OptiBoard Silver Supporter Quince's Avatar
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    That is an interesting article. I do wonder if different races produce different results, as it specifies that this particular study was done with a Turkish population. Not that I think it would effect the overall answer of 'yes, there is change between certain age ranges' but it makes me think of the tells that archaeologists can read to identify age/ sex/ race from bone structure.
    Have I told you today how much I hate poly?

  7. #7
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by Tallboy View Post
    That is really interesting Robert, thank you for that article.
    Your welcome.

    Quote Originally Posted by Quince View Post
    That is an interesting article. I do wonder if different races produce different results, as it specifies that this particular study was done with a Turkish population. Not that I think it would effect the overall answer of 'yes, there is change between certain age ranges' but it makes me think of the tells that archaeologists can read to identify age/ sex/ race from bone structure.
    They do- one study shows no change. I see primarily European females.

    Best regards,

    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    An expert is a man who has made all the mistakes which can be made, in a narrow field. -Niels Bohr

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    Hello everyone.

    I'm an optometrist student from Italy, sorry for my bad English... I'm improving :)

    this thread is Very interesting.

    The questions sometimes Is (I think so..) Do I use old Pd or "upgrade new pd?" (in all lenses...single vision like progressives)

    the optical science says.. with exact true Pd I cut off unwanted prism.... but the patient is get to used the "old" pd... maybe from years... have the habit maybe with those little prism effects...

    Am I "mad"??? I saw some people with new glasses that in single vision lenses prefer the old wrong pd on the old glasses..

  9. #9
    Ghost in the OptiMachine OptiBoard Silver Supporter Quince's Avatar
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    Quote Originally Posted by dima View Post
    Hello everyone.

    I'm an optometrist student from Italy, sorry for my bad English... I'm improving :)

    this thread is Very interesting.

    The questions sometimes Is (I think so..) Do I use old Pd or "upgrade new pd?" (in all lenses...single vision like progressives)

    the optical science says.. with exact true Pd I cut off unwanted prism.... but the patient is get to used the "old" pd... maybe from years... have the habit maybe with those little prism effects...

    Am I "mad"??? I saw some people with new glasses that in single vision lenses prefer the old wrong pd on the old glasses..

    This is another good thread about 'updating' a PD.

    https://www.optiboard.com/forums/sho...-It-s-me-again

    While it is true that patients can become accustomed to a mismeasured PD or Seg, I find most people in the field agree that you should always try to use the most accurate measurements unless there are documented past issues.
    Have I told you today how much I hate poly?

  10. #10
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    Quote Originally Posted by Quince View Post
    This is another good thread about 'updating' a PD.

    https://www.optiboard.com/forums/sho...-It-s-me-again

    While it is true that patients can become accustomed to a mismeasured PD or Seg, I find most people in the field agree that you should always try to use the most accurate measurements unless there are documented past issues.
    Thanks Quince :)

    ps... also I... hate poly very much ;)

  11. #11
    Ghost in the OptiMachine OptiBoard Silver Supporter Quince's Avatar
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    Quote Originally Posted by dima View Post
    Thanks Quince :)

    ps... also I... hate poly very much ;)
    There is a secret society of us poly haters! Welcome!
    Have I told you today how much I hate poly?

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    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Always remember it's the binocular PD that matters most, not monocular

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    Quote Originally Posted by Barry Santini View Post
    Always remember it's the binocular PD that matters most, not monocular
    Thanks Barry.

    I'm wondering (sorry I start my studies from few months) if I have a person (no amblyopia or binocular defect) with a strong "ocular dominance" (sorry for my English) It is the same? the pd meter will be correct?

    My OD because I have a little lack on the left eye (strong ocular dominance on the right eye) take mono pd and after take binocular after I blink for fusion.

    It is correct or madness? hahahha :)
    Last edited by dima; 11-12-2017 at 09:33 AM.

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    Quote Originally Posted by Barry Santini View Post
    Always remember it's the binocular PD that matters most, not monocular
    This is not a true statement in a +2.25 progressive though is it?

  15. #15
    Ghost in the OptiMachine OptiBoard Silver Supporter Quince's Avatar
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    Quote Originally Posted by Barry Santini View Post
    Always remember it's the binocular PD that matters most, not monocular

    Maybe this is a good segue or maybe I should look up a thread that already discussed this, but I would think the opposite. I use binocular PD for all line segmented multifocals- mainly for cosmetic reasons, but aside from that always use monocular measurements.
    Have I told you today how much I hate poly?

  16. #16
    Master OptiBoarder OptiBoard Silver Supporter Barry Santini's Avatar
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    Quote Originally Posted by Tallboy View Post
    This is not a true statement in a +2.25 progressive though is it?
    Absolutely!!

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